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The Playbook for Building Win-Win Startup Partnerships
Todd Dunn, Director of Innovation, Intermountain Healthcare, Inc.
Santosh Mohan, Member, HIMSS Innovation Committee
Innovation Preconference Symposium Session INV4, February 11, 2019
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Today’s Speakers
Santosh Mohan, MMCi FHIMSS
Member
HIMSS Innovation Committee
Twitter: @santoshSmohan
Todd Dunn
Director of Innovation
Intermountain Healthcare, Inc.
Twitter: @TToddDunn
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Todd Dunn
Has no real or apparent conflicts of interest to report.
Santosh Mohan, MMCi, CPHIMS, FHIMSS
Has no real or apparent conflicts of interest to report.
Conflict of Interest
4
• Discuss needs and sustainable approaches for engaging
entrepreneurs to delve into improvement opportunities
• Examine tools and approaches for rapidly identifying and
assessing high performing technology partnerships through
streamlined decision-making
• Explore ways to structure a startup partnership with shared vision,
success metrics, and sense of urgency to drive mutual success
• Review top tactics to identify champions, consider integration
elements, address dependencies, and overcome biggest adoption
hurdles
Learning Objectives
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Acknowledgements
Clayton Christensen
Boston, MA
Intermountain Healthcare
Salt Lake City, UT
Bert Zimmerli
Chief Finance Officer
Marc Probst
Chief Information Officer
Kevan Mabbutt
Chief Consumer Officer
Rock Health
San Francisco, CA
Venture Valkyrie
Mill Valley, CA
Lisa Suennen
The Re-Wired Group
Detroit, MI
Bob Moesta
athenahealth
Watertown, MA
Michael Palantoni
Executive Director, Platform Strategy And Operations
Atrium Health
Charlotte, NC
Rasu Shrestha
Executive Vice President and Chief Strategy Officer
AVIA
Chicago, IL
Brigham Digital Innovation Hub
Boston, MA
Adam Landman, MD, MS, MIS, MHS
Chief Information Officer, Brigham Health
Josie Elias
Program Manager
Mark Zhang DO, MMSc
Medical Director
Chen Cao
Innovation Analyst
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7
Yaw Pitch Roll
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Source: AHA and AVIA Digital Innovation Report 2017
Digital Innovation a top priority
85%
75%
76%
75%
“ …a priority at our health system”
“ …tied to our long-term strategy”
“…essential to meeting long-term goals
and metrics”
“…pursuing it is necessary for a
competitive advantage”
10
76%
leaders believe that innovation includes partnering with other innovative
organizations
42%
leaders believe that innovation includes testing and scaling externally-
developed digital solutions made by small to medium-sized solution companies
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Direct startup
partnerships
Events
(hackathons, pitch
competitions,
demo days etc.)
Incubators and
accelerators
External
partnerships
Startup
investments
Co-Working
spaces and labs
Co-development,
APIs, App Stores
Acquisitions
and spin-offs
12
Key Challenges
Divergent Risk Profiles
Differing Motivations
Distinct Cultures
Complex Regulations
13
14
15
Who to Blame
Frederick Winslow Taylor
(1856 – 1915)
16
“Jobs-to-be-done
offers a clear way
to innovate.”
Clay Christensen, HBS
17
18
Three C’s of Design Disease
Conference Rooms
Conference Calls
Cubes
Context (their Cambodia)
19
Three core principles
20
21
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Key Partnerships Key Activities Value Proposition Customer
Relationships
Customer Segments
Key Resources Channels
Cost Structure Revenue Streams
DESIRABILITY: CUSTOMER
DEVELOPMENT
FEASIBILITY:
BUILD, BORROW, BUY?
VIABILITY
SANITY CHECK
23
Value Proposition Canvas
24
25
What
you
do
26
27
28
HEALTHCARE SHIFT TO FEE FOR VALUE
29
30
31
1
2
3
4
5
Vague success metrics
Open-ended sponsor roles
Failure to understand operational realities
Runaway vaporware
Poor contracts lacking long-term commitment
Innovative
technologies
$
New revenue streams
33
“We should be the partner of
choice for innovators across the
digital health landscape.”
34
Innovation
Bleeding Edge
Settled
Scale
Researcher/Clinic
Hospital-wide
2-3 Departments
Integrating novel
w/existing
System-wide
Stable tech
1-2 clinics
Advancing ideas
Key factors for translating pilots to implementation
Source: Tseng, Jocelyn, et. al. “Catalyzing Healthcare Transformation
with Digital Health: Performance Indicators and Lessons Learned from
a Digital Health Innovation Group.” Healthcare, 25 Sept. 2017.
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The DHIG governance process reduces risk for both individual projects and
for the broader organization, improving the likelihood success by ensuring
proper approvals and best practices are followed.
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Material may be prepared and shall be made freely avai lable under identical terms and condit ions of the License; and (3) attribution must be given
to Brigham & Women’s Hospital.
All terms and conditions of the Licen se are available her e:
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*Listed assets may be available upon request. Please contact us at bwhihub.org or email ihub@partners.org for more information.
Rev 1.4 – May 15, 2017
Digital Health Innovation Guide (DHIG) Checklist
Requirement
Description
Assets
Contracting & Legal
Business Associate Agreement
(BAA)
Agreement between the vendor and
subcontractors who will be performing a
service on behalf of the institution and will
have access to patient health information
(protected health information or “PHI”).
Brigham and Women’s Hospital
(BWH) standard BAA template*
Statement of Work (SOW)
Agreement between innovator and vendor
as to pilot scope. Used for contracting
purposes and must be signed off by supply
chain for a PO to be issued. Substantial
modifications or enhancements to develop
should consider a new SOW.
Partners HealthCare System
(PHS) standard SOW template*
Support for Product During
Pilot
It is the application owner's responsibility
to provide application support for all users.
Discuss with your client how you will
manage issues and turnaround time.
Terms and Conditions (T&C)
Review
T&C for patients and other users must be
approved by client's legal.
Sample T&C document*
Marketing
& Public
Affairs
Reference Hospital in
Marketing/PR
Approval for any planned project PR must
be discussed with hospital in advance.
There can be limits on how to incorporate
hospital in marketing/PR.
Publishing
Results
Research or Quality
Improvement (QI) Submission
Pilots need to determine if an IRB review is
required for research purposes or if the
proposed activity is clinical quality
improvement/measurement, in which case
IRB review is not required. If a pilot is
research, then the IRB approval must be
complete prior to launch. This should also
be included in the SOW.
Clinical Quality Improvement
checklist*
Security
Security Risk Assessment
Security review of the app to ensure that it
will be safe within hospital environment.
This is also where HIPAA compliance is
addressed.
BWH IS standard vendor
cybersecurity risk assessment
form*
Security Scans
A subcomponent of the risk assessment:
May include Veracode and Qualys scans,
depending on product design.
CHECKLIST-DRIVEN PROCESS
Pre-approved/customizable guardrails and
regular check-ins keep projects on track
CROSS-FUNCTIONAL GUIDANCE
Information Security, Partners eCare,
Compliance, IRB, Partners Innovation and
other teams
PROJECTS
REVIEWED
100+
AVERAGE TIME FROM
INTAKE TO PILOT
FOR PROJECTS WHICH ULTIMATELY
EXECUTED A PILOT
9
MONTHS
IMPACT TO DATE
Digital Health Innovation Guide (DHIG)
Source: Tseng, Jocelyn, et. al. “Catalyzing Healthcare Transformation with Digital Health: Performance
Indicators and Lessons Learned from a Digital Health Innovation Group.” Healthcare, 25 Sept. 2017.
DHIG Supported Implementation Pathway
Project-Based Monitoring and Detail Checklists Track for Progress and Pitfalls
Task-level detail
• All items
• Notes/comments
• Assignees
• Resource links
• Task Status
Key project indicators
• Goals
• Contacts
• Task Status
• Issues
• Files
Source: Elias, J., Zhang, H. (2018, March 1).
Telephone interview. Brigham Digital Innovation Hub.
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The pathway to sustainable operations
INNOVATION COORDINATION
OPERATION
Early Stage
Ideation
Pilot
Handoff
Assessment
Planning
Support
Scale
Manage
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The AMA is committed to making technology an asset, not a burden, and
the playbook provides the medical community with widespread access to
a proven path for implementing digitally enabled health and care.
Dr. Jesse M. Ehrenfeld, AMA chair elect
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AMA Digital Health Implementation Playbook
Best practices shared by 80+ nationwide physicians, patients, care
team members, administrators, and entrepreneurs
Practical guide leading from identifying the need and forming a team
to contracting to partnering and evaluating the success
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Download the Playbook here:
https://www.ama-assn.org/amaone/ama-digital-health-
implementation-playbook
“Accelerating the pace of digital health adoption requires an
efficient and proven path to success, but best practices are not
widely shared. The Playbook responds to a growing
demand for proven guidance that physicians and care
teams need to successfully integrate effective digital
solutions into practice.”
Michael Hodgkins, MD
AMA Chief Medical Information Officer
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Rise of the App Stores of the EHRs
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Cut down integration
costs and
implementation time
Lower investment
and risk
Shopping experience –
choice of similar
functionality within category
Filter signal from noise –
glean from peer reviews
and best practices
Eliminate RFP process Agile pilots – try
before you buy
Benefits of App Stores
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Discussion
48
We all need a flight plan
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Develop a standard process
Invest in IT resources
Implement a flexible budget cycle for operations staff
Source: AHA and AVIA Digital Innovation Report 2017
We all need a flight plan
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Source: “Healthcare IT startups have become too willing to accept pilot status,” Lisa Suennen,
MedCityNews, May 2016, available at https://medcitynews.com/2016/05/healthcare-startups-
become-willing-accept-pilot-status/, accessed March 2, 2018; Interviews and research
Think hard about whether
a pilot is really necessary
Only pilot what you intend to buy
Don’t measure success by
# of pilots; have the right approach
Pay vendors for pilots
Render an early verdict – if it’s clear
the pilot isn’t working, stop it early
Be honest with yourself about how
much customization you really need
Pilot products are not perfect
– build your own if you
need them to be perfect
Put your A team
on the pit crew
Additional Considerations
Clarify expectations upfront
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Thank you!
